Issue: 2006 > July-August > original article

Establishment of reference values for endocrine tests - part V: acromegaly

E. Endert, M. van Rooden, E. Fliers, M.F. Prummel, W.M. Wiersinga


Background: Plasma insulin-like growth factor 1 (IGF-1)
and the response of growth hormone (GH) to oral glucose are frequently used in the evaluation of patients suspected of acromegaly. Because of the implementation of new assay methodology for GH and IGF-1, we have established the reference values for these tests, as well as for urinary GH excretion.
Methods: From the general population, 50 subjects were
recruited, equally distributed according to sex and age
between 20 and 70 years. Two consecutive 24-hour urine
samples were collected to determine urinary GH. Plasma
IGF-1 was measured as well as the GH response during an oral glucose tolerance test (OGTT) with 100 g glucose. Basal plasma IGF-1 was also measured in 250 subjects recruited likewise from the general population who had participated in previous studies on reference values.
Results: The following reference ranges were established: urinary GH <5-46 &mu;U/24 h; nadir GH after OGTT &le;1.5 mU/l for males and &le;2.0 mU/l for females. IGF-1 was divided into age groups: 20-30 years 8-61 nmol/l; 31-40 years 8-41 nmol/l; 41-50 years 7-36 nmol/l; 51-60 years 5-37 nmol/l; and 61-70 years 7-27 nmol/l.
Conclusion: We have established reference values with state-of-the-art assay methodology for the diagnostic tests frequently used in the evaluation of patients suspected of acromegaly.